Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp . (20.3%), Escherichia coli (15.8%), and Pseudomonas spp . (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-022-06944-2.

Background: Adolescence is defined by WHO as period in human growth and development that occurs after childhood and before adulthood from ages 10 to 19 years. According to WHO, half of all mental health disorders in adulthood start by age 14 years, but most cases are undetected and untreated.Methods: The present study was community based cross sectional comparative study was conducted on study participants were high school children aged 14 years to 16 years in tribal, rural and urban areas of Mysuru from November 2014 to May 2016, i.e., one and a half years (eighteen months). Around 9 tribal high schools, 8 rural high schools and 13 urban high schools were selected and sampling was done according to probability proportionate to size. Institutional Ethics Committee clearance was obtained before start of the study. The study methodology was discussed with and permission obtained from all Principals and Headmasters of respective High Schools. Written informed assent was obtained from each study participant. Data thus Obtained were coded and entered into Microsoft excel Work sheet .This was analyzed using SPSS 22 version. Descriptive statistics like percentage, mean and standard deviation were applied. Inferential statistical tests like chi square test were applied to find out association. The difference, association were expressed statistically significant at p-value less than 0.05.Results: Among the study participants, in tribal area, 88 (47.3%) belonged to age group of 15 years, in rural area, 103 (51.5%) belonged to age group of 15 years and in urban area 116 (59.8%) belonged to age group of 14 years. Anxiety disorders were seen more in urban participants 26.3% and least in rural, major depressive disorders were seen more in urban participants (4.1%) and suicidality was seen more in rural participants (6.5%).Conclusions: Anxiety disorders were seen more in urban participants 26.3%, Major depressive disorders were seen more in urban participants (4.1%) and suicidality was seen more in rural participants (6.5%). The present study stresses importance of School-based specific diagnostic screenings such as for anxiety disorders, depression, ADHD should be implemented.

Context:Tobacco is a leading cause of disease and premature death. Most of the smokers visit a doctor for various health related ailments and thus such clinic visits provide many opportunities for interventions and professional tobacco cessation advice.Aims:The primary aim of the following study is to assess the physician practices, perspectives, resources, barriers and education relating to tobacco cessation and their perceived need for training for the same. The secondary aim is to compare the physician's cessation practices from patient's perspective.Settings and Design:A descriptive study was conducted in a hospital attached to Medical College in Mysore city, Karnataka.Materials and Methods:Information about doctor's practices, perspectives and their perceived need for training in tobacco cessation were collected using pre-structured self-administered Questionnaire, which were distributed in person. Patient's practices and perspectives were assessed using a pre-structured Oral Questionnaire.Results:Almost 95% of physicians said that they ask patients about their smoking status and 94% advise them to quit smoking, but only 50% assist the patient to quit smoking and only 28% arrange follow-up visits. Thus, they do not regularly provide assistance to help patients quit, even though 98% of the physicians believed that helping patients to quit was a part of their role. Only 18% and 35% of the physicians said that Undergraduate Medical Education and Post Graduate Medical Education respectively prepared them very well to participate in smoking cessation activities.Conclusions:Tobacco cessation requires repeated and regular assistance. Such assistance is not being provided to patients by attending doctors. Our medical education system is failing to impart the necessary skills to doctors, needed to help patients quit smoking. Reforms in education are needed so as to prepare the physician to effectively address this problem.

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